POS1343 INFLUENCE OF REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION OF CNS ON FIBROMYALGIA PATIENTS - A RANDOMIZED, DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY (INTERIM ANALYSIS)
Authors: Z. Veličković, S. Radovanović, G. Radunovic
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Fibromyalgia syndrome (FMS) is a chronic disorder characterized by diffuse pain, sensitivity to sensory stimuli, fatigue, cognitive impairment, mood and sleep disorder. The side effects of drugs used in treatment (i.e. antiepileptics) can mimic certain symptoms of fibromyalgia (i.e. impaired balance, dizziness), so there is a huge need for alternative treatment. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive therapy utilizing a magnetic field to stimulate different brain structures. rTMS is registered as adjuvant therapy for major depressive disorder, migraine, and obsessive-compulsive disorder, and its efficacy is being investigated for other conditions. <h3>Objectives</h3> The main aim was to evaluate the influence of rTMS in alleviating the symptoms in patients with fibromyalgia. <h3>Methods</h3> Sixteen patients were randomized to rTMS (n=10) or sham treatment (n=6). rTMS was applied in 10-day sessions with a frequency of 10 Hz and an intensity of 130% of the predetermined motor threshold over the left dorsolateral prefrontal cortex (DLPFC). One session of rTMS consisted of 5 seconds of stimulation (frequency of 10 Hz, for a total of 50 stimuli) and a 10-second pause. Patients received 2000 stimuli per day (50 stimuli in 40 repeated sessions). The placebo was applied with an inactive "sham" coil which resembles active treatment. The intensity of symptoms was assessed with Tender Point Examination (TPE), Visual Analog Scale of Pain (VAS), Brief Pain Inventory (BPI), Beck Depression Inventory II (BDI II), Beck Anxiety Inventory (BAI), Montreal Cognitive Assesment (MoCa), Medical Outcome Studies Sleeping Scale (MOS SS), Functional Assesment of Chronic Illness Therapy – Fatigue (FACIT-F), 36-item Short Form Survey (SF-36), and Revised Fibromyalgia Impact Questionnaire (FIQR). <h3>Results</h3> There was no difference between groups in any of the characteristics at baseline. There was a decrease in BDI score after the treatment period, but the change was more prominent in the rTMS group compared to the placebo (p=0.064). rTMS was also superior in a decrease in FIQR score (p=0.054) (Table 2.) and an increase in vitality through SF-36 (p=0.003). Moreover, placebo treatment led to a significant reduction in sleep disturbances (p=0.035). There were no differences between groups in delta values before and after treatment regarding the rest of investigated characteristics (Table 1., p&gt; 0.05). <h3>Conclusion</h3> Preliminary results suggest a reduction in the impact of the disease and depression, as well as an increase in the vitality of participants who have been treated with rTMS. The placebo effect on a reduction of sleep disturbance can be partly explained by the stimulating effect of rTMS. Because this was an interim analysis, the presented results should be taken with caution. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.